• Title/Summary/Keyword: MEP

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Application of Intraoperative Neurophysiological Monitoring in Aortic Surgery (대동맥수술에서의 수술 중 신경계감시의 적용)

  • Jang, Min Hwan;Chae, Ji Won;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.61-67
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    • 2022
  • Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.

Evidence of Cortical Reorganization in a Monoparetic Patient with Cerebral Palsy Detected by Combined Functional MRI and TMS

  • Kwon, Yong-Hyun;Jang, Sung-Ho;Lee, Mi-Young;Byun, Woo-Mok;Cho, Yoon-Woo;Ahn, Sang-Ho
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.96-103
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    • 2005
  • The motor recovery mechanism of a 21-year-old male monoparetic patient with cerebral palsy, who had complained of a mild weakness on his right hand since infancy, was examined using functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). The patient showed mild motor impairment on the right hand. MRI located the main lesion on the left precentral knob of the brain. fMRI was performed on this patient as well as 8 control subjects using the Blood Oxygen Level Dependent technique at 1.5 T with a standard head coil. The motor activation task consisted of finger flexionextension exercises at 1 Hz cycles. TMS was carried out using a round coil. The anterior portion of the coil was applied tangentially to the scalp at a 1.0 cm separation. Magnetic stimulation was carried out with the maximal output. The Motor Evoked Potentials (MEPs) from both Abductor Pollicis Brevis muscles (APB) were obtained simultaneously. fMRI revealed that the unaffected (right) primary sensori-motor cortex (SM1), which was centered on precentral knob, was activated by the hand movements of the control subjects as well as by the unaffected (left) hand movements of the patient. However, the affected(right) hand movements of the patient activated the medial portion of the injured precentral knob of the left SM1. The optimal scalp site for the affected (right) APB was located at 1 cm medial to that of the unaffected (left) APB. When the optimal scalp site was stimulated, the MEP characteristics from the affected (right) APB showed a delayed latency, lower amplitude, and a distorted figure compared with that of the unaffected (left) APB. Therefore, the motor function of the affected (right) hand was shown to be reorganized in the medial portion of the injured precentral knob.

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Effect of Monascus Pigment Extract on the Alcohol Metabolism in Rats (흰쥐에 있어서 홍국 색소 추출물이 알코올대사에 미치는 영향)

  • 유대식;최혜정;윤종국
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.4
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    • pp.603-607
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    • 2003
  • To investigate the alcohol metabolizing system in liver of rats drunken 10% ethanol with Monascus pigment extract (MPE), Sprague-Dawley male rats weighing about 250 g have been drunken 10% ethanol containing 1, 2.5 and 5% Monascus pigment extract for a month. Three groups of rats drunken 10% ethanol with MPE gained somewhat less body weight than normal group, but the changes of body weight was not significantly different among the former groups. All groups drunken MPE supplemented alcohol had no remarkable changes in liver function on the basis of liver weight/body weight, the serum levels of alanine aminotransferase and xanthine oxidase activity. 10% alcohol drunken animals (control group) showed significantly increased activity of hepatic alcohol dehydrogenase (ADH) by 87% compared with normal group and the animals drunken 1%, 2.5% and 5% MPE showed respectively 34%, 29% and 21% increased activity of hepatic ADH, whileas Km value of ADH in 1, 2.5 and 5% MPE group decreased by 40%, 30% and 19% respectively compared with the control, but Vmax showed no significant changes among MPE groups. In case of aldehyde dehydrogenase (ALDH), 1% MPE group showed significantly increased activity by 32% and 2.5% or 5% MPE group showed increasing tendency compared with control, and Km value in three experimental groups declined by 27% and no particular changes were found among those. Furthermore, Vmax value in 1, 2.5 and 5% MEP group increased by 88,56 and 22% respectively with the control. In the aspect of the area under the curve of a ethanol concentration versus time (AUC) profile obtained after administration of 10% alcohol with 1 or 5% MPE, the decreasing rate of AUC to the control was 18% in 1% MPE treated rats whereas 10% in 5% MPE group.

Studies on the Stability of Fenitrothion Formulations (Fenitrothion (MEP) 제제(製劑)의 화학적(化學的) 안정성(安定性)에 관(關)한 연구(硏究))

  • Park, Seung Heui
    • Korean Journal of Agricultural Science
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    • v.2 no.2
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    • pp.381-398
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    • 1975
  • Present work was executed to evaluate effects of adjuvants. stabilizers. moisture. pH and heavy metals on the stability of Fenitrothion in the emulsifiable concentrate. In addition, susceptibility ' of Fenitrothion in various formulations, to UV-irradiation has been also examined. The results are summarized as follows; 1. Xylene and benzene were found to be satisfactory solvents for Fenitrothion emulsifiable concentrate. As expected, polar sol vents such as aliphatic alcohols considerably reduced stability of the pesticides. 2. Of the two non-ionic emulsifiers, an alkyl aryl type Sorpol-1200, in contrast to sorbitan type Tweens, substantially reduced decomposition of Fenitrothion in the emulsifiable concentrates. Moisture and pH of emulsifiers. in the ranges studied. affected little if any. on the stabi ity of the Fenitrothion during the experiment periods. 3. Maleic anhydride, p-toluene sulfonic acid, sulfosalicylic acid, maleic anhydride-sulfosalicylic acid reduced decomposition of Fenitrothion in the emulsifiable concentrate. Addition of organic acids, however, increased liability of Fenitrothion in the emulsifiable concentrate. 4. Presence of either zinc or copper metals in the emulsifiable concentrate containing Tween-80 as a emulsifier, reduced stability of the Fenitrothion. 5. UV-irradiation, as expected, brought decomposition of Fenitrothion. The liability of Fenitrothion formulations decreased in the order, wettable powder ${\gg}$ dust > emulsifiable concentrate.

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Arthroscopic Anterior Debridement and Mini-Open Posterior Resection for Primary Osteoarthritis of the Elbow (주관절 원발성 골성 관절염의 관절경적 전방 변연 절제술 및 최소 절개 후방 절제술)

  • Kim, Young-Kyu;Moon, Sung-Hoon;Cho, Seung-Hyun;Oh, Won-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.40-46
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    • 2012
  • Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

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The Clinical Usefulness of the Minimal Invasive Ulno-humeral Arthroplasty in the Patients with Mild to Moderate Elbow Arthritis (경도 및 중등도 주관절 관절염 환자에서 최소 침습적 척골-상완 관절 성형술의 임상적 유용성)

  • Kim, Bo-Kun;Shin, Hyun-Dae;Kim, Kyung-Cheon;Cha, Soo-Min
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.73-79
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    • 2011
  • Purpose: To evaluate of the clinical usefulness of minimal invasive ulnohumeral arthroplasty in patients with mild to moderate elbow arthritis. Materials and Methods: From January 2000 to December 2008, twenty-nine patients with mild to moderate elbow arthritis underwent minimal invasive ulnohumeral arthroplasty. Among these patients, we reviewed the cases of 24 patients for whom we had follow-up data for at least 1 year. There were 20 males and 4 females with a mean age of 53 years (range: 31~69). We excluded patients with preoperative ulnar neuropathy symptoms and investigated the mean operation time, the joint range of motion, the time required until the start of joint exercise, and the Mayo elbow performance score (MEPS). Results: Passive and active joint exercises were started in an average of 1.8 days (range: 1~4) after surgery; the mean operation time was 38 minutes (range: 25~55). The elbow joint range of motion was 25-104 degrees (extension 0~70, flexion 80~130) preoperatively and was improved 40 degrees on average to 14-133 degrees (extension 0~45, flexion 90~150) after a year of follow up. The average time required until the start of joint exercise was 1.6 days (range: 1~5). MEPS were excellent in 9 cases and good in 5 cases after a year of follow up. Although there was 1 case of delayed wound healing and 7 cases of postoperative edema, they improved spontaneously. Conclusion: For patients with mild to moderate elbow arthritis, minimal invasive ulnohumeral arthroplasty is a clinically useful surgery since its operation time is short, early joint exercise is possible, and pain is mild.

Results of Arthroscopic Debridement of the Elbow Osteoarthritis (주관절 골관절염에서 관절경적 변연절제술 후 결과)

  • Chun, Churl-Hong;Kim, Jung-Woo;Lim, Jae-Chang
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.53-60
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    • 2009
  • Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique (압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.159-166
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    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.